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Tijdschrift voor Psychiatrie 56 (2014) 5, 299 - 306

New research

Somatic disorders in outpatient psychiatry: the added value of a standard physical examination during the intake of outpatients

K.E.M. van de Berg, C.A.Th. Rijnders, A. van Dam, A.L.M. van de Ven, C.M. van der Feltz-Cornelis, S.J. Graafsma

background It is well-known that psychiatric patients often suffer from severe somatic problems, such as diabetes mellitus and cardiovascular disease. Up till now, research has concentrated almost exclusively on the inpatient setting, but there is strong evidence that the correlation also exists in psychiatric patients who are outpatients. In the Netherlands there are, as yet, no clear recommendations regarding a standard form of somatic screening for the outpatient population. A pilot study performed by GGz Breburg has shown that somatic screening (without a physical examination) gave substantial additional value to treatment planning.
aim To investigate the added value that a physical examination can provide when new psychiatric patients are screened for aspects of somatic concern (asc).
method Newly referred outpatients (n = 70) were screened somatically by means of a questionnaire and supplementary medical interview, and by laboratory tests and physical examination. If a somatic problem was found which had not been detected previously, the patient was referred back to to the general practitioner.
results At least one asc was found in 81,4% of all patients. In 45,7% of all patients the asc had not been detected. 12% of all the newly discovered somatic problems were found exclusively via the physical examination.
conclusion A physical examination provides substantial information and adds value to the somatic screening of psychiatric outpatients.

keywords physical examination, psychiatric outpatients, somatic disorder, somatic screening